Four patients who had multisegmental ankylosis of the thoracic and
lumbar spine due to diffuse idiopathic skeletal hyperostosis sustained a
hyperextension fracture-dislocation. The patients had a mean age of
sixty-four years (range, fifty-eight to sixty-nine years); all four
patients were men. All injuries occurred between the seventh and eleventh
thoracic vertebrae. All patients had intact neurological function at the
time of admission to the hospital. Three patients were managed with
posterior spinal arthrodesis with Cotrel-Dubousset segmental
instrumentation; one patient was managed non-operatively with a molded
thoracolumbosacral orthosis. At a minimum duration of follow-up of
twenty-two months (mean, twenty-seven months), the three patients who had
been managed operatively had healing of the fracture with anatomical
alignment of the spine and without postoperative complications. The one
patient who had been managed non-operatively with a brace had severe
neurological deterioration and non-anatomical alignment of the spine.